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伴有神经内分泌分化的同步性肝细胞癌和胆囊腺癌:一例报告及文献复习

Synchronous hepatocellular carcinoma and gallbladder adenocarcinoma with neuroendocrine differentiation: a case report and literature review.

作者信息

Xu Yan, Chen Quan-Ning, Wang Hui, Liu Nan-Bin, Shi Bao-Min

机构信息

Department of General Surgery, Tongji Hospital, Tongji University Medical School, Shanghai, 200065, People's Republic of China.

出版信息

BMC Surg. 2020 Oct 20;20(1):246. doi: 10.1186/s12893-020-00905-6.

Abstract

BACKGROUND

Double primary cancers have a low incidence rate, and synchronous hepatocellular carcinoma and gallbladder adenocarcinoma are rarely reported. Here, we report such a case- the 12th case of synchronous double primary cancers featuring HCC and GC, but the first case of neuroendocrine differentiation in the gallbladder.

CASE PRESENTATION

A 77-year-old female was admitted to the hospital complaining of weakness and inappetence for six months. Contrast-enhanced computed tomography (CT) of the abdomen indicated an 11 cm space-occupying lesion in the right lobe of the liver. Later, magnetic resonance imaging showed a high possibility of a massive hepatoma, and multiple gallstones were also seen. After transhepatic arterial chemoembolization, a repeat abdominal CT showed obvious local nodular thickening in the gallbladder wall. Finally, resection of the right lobe of the liver and cholecystectomy were performed. During an approximately 2-year follow-up, the patient recovered uneventfully without recurrence or metastasis.

CONCLUSION

The disease in this case is rare and lacked typical radiological features. More precise and advanced diagnostic techniques are needed to obtain a clear diagnosis and refine treatment strategies. The management strategy should always be curative, even in the presence of multiple malignancies.

摘要

背景

双原发性癌发病率较低,同时发生肝细胞癌和胆囊腺癌的情况鲜有报道。在此,我们报告这样一例病例——这是第12例同时发生肝细胞癌(HCC)和胆囊癌(GC)的双原发性癌病例,但却是胆囊具有神经内分泌分化的首例。

病例介绍

一名77岁女性因乏力和食欲不振6个月入院。腹部增强计算机断层扫描(CT)显示肝脏右叶有一个11厘米的占位性病变。随后,磁共振成像显示高度怀疑为巨大肝癌,同时还发现多发胆结石。经肝动脉化疗栓塞术后,复查腹部CT显示胆囊壁有明显的局部结节增厚。最后,实施了肝右叶切除术和胆囊切除术。在大约2年的随访期间,患者恢复顺利,无复发或转移。

结论

该病例所患疾病罕见且缺乏典型的放射学特征。需要更精确和先进的诊断技术以明确诊断并优化治疗策略。即使存在多种恶性肿瘤,治疗策略也应始终以治愈为目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/649f/7576745/26eb727fdd2a/12893_2020_905_Fig1_HTML.jpg

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